High Prevalence of Acquired Antimicrobial Resistance Unrelated to Heavy Antimicrobial Consumption

Abstract

In a very remote rural Bolivian community where the use of antimicrobials has been minimal and where exchanges with the exterior are very limited, 67% of subjects were found to be carriers of fecal Escherichia coli with acquired resistance to >/=1 antimicrobial agent(s); the highest rates were observed for tetracycline (64%), ampicillin (58%), trimethoprim-sulfamethoxazole (50%), and chloramphenicol (41%). The most relevant implication of these findings is that, in certain settings, the spread and maintenance of antimicrobial resistance can occur, regardless of whether selective pressure generated by the use of antimicrobials is present.

Risk Factors for Antibiotic-Resistant Escherichia coli Carriage in Young Children in Peru: Community-Based Cross-Sectional Prevalence Study

“…15,18,21 Conditions of poor sanitation are thought to play an important role in the widespread dissemination of resistant fecal bacteria in developing countries, 25,26 but the degree of risk in such settings caused by medical versus agricultural use of antibiotics is unclear. Ours is the only study we know of that examines the contribution of the community level exposure to agriculturally introduced resistance together with a host of other potentially important risk factors for young children's carriage of antibiotic-resistant E. coli in a developing country setting with poor sanitation.…”

“…Environmental contamination disseminates resistant organisms, particularly in developing countries because of crowding and inadequate excreta management. 25,26 Resistant bacteria have been detected in drinking water, 27 vegetables, fish, 28 and marine sediments. 29 Sources include human sewage, farm runoff, and integrated fish farming.…”

Antibiotics and the gut microbiota

“…Because the human immune system responds to microbial cues and regulates community composition, bacterial subversion and cooperation are not uncommon as means for maintaining homeostatic conditions for occupancy (42). The potential fragility of the population structure in the face zation of the intestine by resistant bacteria can occur within three days of birth (33); additionally, resistance phenotypes have been documented in remote human communities with limited exposure to antibiotics (34).…”

Antagonistic effects of three lactic acid bacterial strains isolated from Nigerian indigenous fermented Ogi on E. coli EKT004 in co-culture

“…Some studies have already shown that E. coli often resist antibiotics such as ampicillin, amoxicillin-clavulanic acid, cotrimoxazole, nalidixic acid, and cephalothin (ALSHARA, 2011). Several factors result in increasing antimicrobial drug resistance rates in poor countries such as irrational antimicrobial drug usage and conditions of poor sanitation (OKEKE et al, 1999;BARTOLONI et al, 2006;TOBIH et al, 2006).…”